Wide and Fast (ECG)

[fiznat]

42 year old guy in good general health (albeit obese) complaining of an acute onset of weakness, diaphoresis, and shortness of breath while sitting at his desk at work. No pain or chest discomforts. BP is 128/82, he's pale and soaking wet. No medical history/meds/etc....

Have at it!

Edited January 16, 2011 by fiznat

[Eydawn]

Haven't had any cardiology to speak of, so I can't really read the strips other than to go WOW! Could it be wide complex V-tach that I'm seeing in the three lead? As far as the 12 I won't hazard a guess at what else may be going on... but that's my first guess based on the three lead, based on the presence of regular peaks of the same size and width apart (too wide but really fast rate).

Wendy

CO EMT-B

[DwayneEMTP]

Initial impression?

Pulse quality?

Mentation level?

Anxiety level?

Skins?

Going to leave it there for now so many can play.

Thanks for this Fiz...these can be scary calls.

Dwayne

[island emt]

keeping my keyboard silent so Dwayne doesn't yell at me !!!!!!!!!!!!!!

:-}

[JTpaintball70]

If all I saw was the strip, I might be puckering up and reaching for the pads... I kinda wanna know what Dwayne was asking too. Looks to me a like a V-tach.

[fiznat]

Initial impression?

Pulse quality?

Mentation level?

Anxiety level?

Skins?

My initial impression was that the guy looked like crap! haha. He was pale, and profusely diaphoretic. His t-shirt was soaked through like he had been pushing boulders up mountains. Other than that though, he was alert and oriented, carrying on a normal conversation, sounding kindof scared and nervous. Pulse quality was good at the radial artery. Fast though.

Could it be wide complex V-tach that I'm seeing in the three lead?

Not bad for someone with no cardiology training! The first question anyone must ask with these "fast and wide" rhythms is "is this VT?" I'm not going to give up the answer that easy though... haha

Edited January 16, 2011 by fiznat

[Kiwiology]

Looks like VT or torsades, hmmm .... start moving toward hospital, get a running IV line into this bloke and give him some amiodarone

[DwayneEMTP]

keeping my keyboard silent so Dwayne doesn't yell at me !!!!!!!!!!!!!!

:-}

Heh...if you were dumb that wouldn't be a problem!! But I think that the process is more important than the answer brother...

Besides..I didn't yell before..I just asked..in a threatening manner, but quietly.

Thanks for playing! You knowledge and insight is invaluable here...

Dwayne

[crotchitymedic1986]

I am going with an aberrant wide complex tachycardia, not V-Tach, but I would be applying the pads anyway. My guess is the underlying problem is an electrolyte imbalance that is causing the dysrythmia, but it could be an MI. It will be interesting to see what the diagnosis actually was.

[mobey]

Looks like VT or torsades, hmmm .... start moving toward hospital, get a running IV line into this bloke and give him some amiodarone

What made you choose drugs over electrical cardioversion?

I am going with an aberrant wide complex tachycardia, not V-Tach, but I would be applying the pads anyway

Agreed on the pads!

what criteria did you use to deduce aberrant tach?